Abstract
OBJECTIVE To analyze spatial changes in the risk of AIDS and the relationship between AIDS incidence and socioeconomic variables in the state of Rondonia, Amazon region. METHODS A spatial, population case-control study in Rondonia, Brazil, based on 1,780 cases reported to the Epidemiological Surveillance System and controls based on demographic data from 1987 to 2006. The cases were grouped into five consecutive four-year periods. A generalized additive model was adjusted to the data; the dependent variable was the status of the individuals (case or control), and the independent variables were a bi-dimensional spline of the geographic coordinates and some municipality-level socioeconomic variables. The observed values of the Moran’s I test were compared to a reference distribution of values generated under conditions of spatial randomness. RESULTS AIDS risk shows a marked spatial and temporal pattern. The disease incidence is related to socioeconomic variables at the municipal level in Rondônia, such as urbanization and human capital. The highest incidence rates of AIDS are in municipalities along the BR-364 highway and calculations of the Moran’s I test show positive spatial correlation associated with proximity of the municipality to the highway in the third and fourth periods (p = 0.05). CONCLUSIONS Incidence of the disease is higher in municipalities of greater economic wealth and urbanization, and in those municipalities bisected by Rondônia’s main roads. The rapid development associated with the opening up of once remote regions may be accompanied by an increase in these risks to health.
Highlights
According to the 2010 World Report on the AIDS epidemic,[11] the incidence of disease is diminishing in southeastern Brazil, and it is stable in the rest of the country, except in the North, where it continues to increase: The incidence rate of AIDS went from 13.6 in 2006 to 20.1 in 2009.b
There were 1,765 cases of AIDS reported among residents of Rondonia from 1987 to 2006, with a progressive increase throughout the four-year periods studied (Table 1)
There was a decrease in individuals in the homosexual/bisexual and intravenous drug use categories and an increase in the percentage and absolute number of heterosexuals affected in the second four-year period
Summary
According to the 2010 World Report on the AIDS epidemic,[11] the incidence of disease is diminishing in southeastern Brazil, and it is stable in the rest of the country, except in the North, where it continues to increase: The incidence rate of AIDS (per 100,000 inhabitants) went from 13.6 in 2006 to 20.1 in 2009.b. Studies have recorded the geographic spread of the epidemic in the Midwestern and Northern states, but little is known about the path of transmission in these regions, which are far from areas where transmission has a longer history. Bol Epidemiol AIDS-DST. 2010;7(1):[4,5,6,7,8,9,10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
